How Will My Doctor Decide If I Need Cholesterol Medicine?

The decision to have you start taking medicine to lower your cholesterol isn't one your doctor will make lightly - because once you start, you usually stay on it for life. The medicine reduces the cholesterol in your blood only while you are taking it. If you stop the medicine, your cholesterol levels will soon return to their unhealthy levels.

Medicines are very helpful in improving cholesterol levels, and they are generally safe when used under a doctor's care. However, as with any medicines, there is always a risk of side effects. Also, some medicines used to lower cholesterol are very expensive. If you have tried your best at lifestyle changes and your cholesterol is still too high, your doctor will consider all of these factors and will choose a medicine that is right for you.

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The main factors your doctor will use to determine whether you need medicine are your age, your LDL level, any other risk factors you have for heart disease, and whether you already have diabetes or any evidence of heart disease. For people with two or more risk factors, it is necessary to get more information to determine the best treatment for you. As of May 2001, the National Cholesterol Education Program recommends using a special tool to assess your risk of heart attack within the next 10 years. Your doctor will use this tool to calculate points based on your age, total cholesterol, HDL cholesterol, systolic blood pressure, treatment for high blood pressure, and whether you have smoked at all in the last month. You can see a version of this test yourself, by taking the National Cholesterol Education Program's Risk Assessment.

Your doctor may recommend medicine if any of these is true.

Your LDL is 190 mg/dL or higher.

Your LDL is 160 mg/dL or higher, you have no evidence of CHD already, but you do have two or more risk factors.

Your LDL is 130 mg/dL or higher, you have no evidence of heart disease already, but you do have two or more risk factors, and your doctor has determined that your risk of developing heart disease over the next 10 years is 10% to 20%.